Successful management of thymic neuroendocrine tumor with paraneoplastic limbic encephalitis.

Abstract

A 42-year-old man was referred to psychiatry with acute onset of confusion and agitation. His screening computed tomography showed middle mediastinal tumors. Preoperative cerebrospinal fluid analysis was positive for anti-contactin-associated protein-like 2 antibody, and possible paraneoplastic limbic encephalitis was diagnosed. Tumour resection was performed. Pathological examination showed thymic neuroendocrine tumour, stage IV. Postoperatively, the patient was treated with everolimus for adjuvant therapy, with complete improvement of encephalitis symptoms. The patient remained well without tumour recurrence or exacerbation of psychiatric disorders for 14 months after surgery.